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Abdom Radiol (NY). 2018 Nov;43(11):3157-3165. doi: 10.1007/s00261-018-1556-6.

Classification of spontaneous isolated superior mesenteric artery dissection: correlation with multi-detector CT features and clinical presentation.

Author information

1
Department of Radiology, Chung-Ang University Hospital, 102 Heukseok-Ro, Dongjak-Gu, Seoul, 06973, Korea.
2
Department of Radiology, Chung-Ang University Hospital, 102 Heukseok-Ro, Dongjak-Gu, Seoul, 06973, Korea. jblee130@gmail.com.

Abstract

PURPOSE:

The purpose of the study is to propose a computed tomography (CT) classification of spontaneous isolated superior mesenteric artery dissection (SISMAD) correlated with clinical presentation METHODS: We retrospectively reviewed CT images of 40 patients with SISMAD at our institution from 2006 to 2015 and proposed a new classification: type I, patent false lumen with both entry and re-entry; type II, patent false lumen without re-entry; type III, completely or partially thrombosed false lumen; and type IV, thrombosed false lumen with ulcer-like projection. Additionally, we included a subtype (S) at each type when there was either a long segment of dissection and/or significant true lumen stenosis. CT features were statistically analyzed using Fisher's exact and Mann-Whitney test.

RESULTS:

The CT findings classified patients as type I (15%), type II (12.5%), type III (35%), and type IV (37.5%). Of the 40 patients, 25 (62.5%) were symptomatic. There was a significantly different proportion of each type between symptomatic and asymptomatic patients (p = 0.005). There were 25 patients with subtype (S); no type I or II, 12 type III, and 13 type IV. The symptomatic patients showed longer dissection tendency and more severe true lumen stenosis (78% vs. 53%, p = 0.000) compared with asymptomatic patients.

CONCLUSION:

The proposed multi-detector CT classification of SISMAD correlates with clinical presentation. This new classification could be helpful for treatment planning.

KEYWORDS:

Classification; Dissection; Mesenteric artery; Multidetector computed tomography; Superior

PMID:
29550960
DOI:
10.1007/s00261-018-1556-6

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